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General NPI Number Information
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NPI Number | 1770833816
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Entity Type | Organization
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Legal Business Name | NORTH AREA MEDICAL GROUP, P.C.
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Dates
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Enumeration Date | 09/17/2012
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Last Update Date | 09/17/2012
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Provider Practice Location Address
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Address Line | 5100 W TAFT RD SUITE 2G
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City | LIVERPOOL
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State | NY
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Zip | 13088-3807
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Country | US
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Telephone | 315-234-8982
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Fax | 315-235-8981
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Provider Business Mailing Address
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Address Line | 5100 W TAFT RD SUITE 2G
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City | LIVERPOOL
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State | NY
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Zip | 13088-3807
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Country | US
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Telephone | 315-234-8982
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Fax | 315-235-8981
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GEETA ROY
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Credential | M.D.
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Telephone | 312-234-8982
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 152461
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License Number State | NY
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